Disease activity measure |
Components |
Interpretation of results |
DASa |
In clinical practice DAS28 (including 28 joints: wrists, metacarpophalangeal joints, proximal interphalangeal joints, elbows, shoulders, knees) is used most commonly. Score is evaluated using a calculator that takes into account: 1) Number of swollen joints 2) Number of tender joints (including 28 joints: wrists, metacarpophalangeal joints, proximal interphalangeal joints, elbows, shoulders, knees) 3) ESR or CRP 4) Patient’s global assessment of disease activity using VAS (0-100) |
Score range: 0-9.4 Interpretation: <2.6: Remission ≤3.2: Low activity >3.2 and ≤5.1: Moderate activity >5.1: High activity Evaluation of treatment response: – Good: Change in activity ≥1.2 and low disease activity – Moderate: Change >0.6 and <1.2 and low or moderate disease activity, or change ≥1.2 and high or moderate disease activity – No response: Change <0.6 or <1.2 and high activity |
SDAI |
Takes into account same joints as DAS28 but does not require a calculator SDAI score = Number of tender joints + Number of swollen joints + Patient’s global assessment of disease activity using VAS (0-10 cm) + Physician’s global assessment of disease activity using VAS (0-10 cm) + Plasma CRP levels (0.1-10 mg/dL) |
Score range: 0.1-86 Interpretation: Score ≤3.3: Remission ≤11: Low activity >11 and ≤26: Moderate activity >26: High activity Evaluation of treatment response: – Significant improvement: Change >21 – Moderate improvement: Change 10-21 – No improvement: Change ≤9 |
CDAI |
Identical to SDAI but does not take CRP into account |
Score range: 0.1-76 Interpretation: Score ≤2.8: Remission ≤10: Low activity >10 and ≤22: Moderate activity >22: High activity |
ACR/EULAR remission criteria |
All must be fulfilled: – Tender joint count ≤1 – Swollen joint count ≤1 – Plasma CRP (mg/dL) ≤1 – Patient’s global assessment of disease activity using VAS (0-10) ≤1 or SDAI ≤3.3 |
Criteria recommended by EULAR for assessment of effectiveness of treatment in clinical practice |
In clinical practice, the CDAI is the most commonly performed measure of disease activity. Other measures are used mainly in research settings. | ||
ACR, American College of Rheumatology; CDAI, Clinical Disease Activity Index; CRP, C-reactive protein; DAS, Disease Activity Score; ESR, erythrocyte sedimentation rate; EULAR, European League Against Rheumatism; SDAI, Simplified Disease Activity Index; VAS, visual analog scale. |